# SISU THERAPY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376391219
- **Authorized official:** JESSICA HAGEN LMFT (THERAPIST)
- **Authorized official phone:** (651) 243-0017

## Contact information

- **Practice address:** 7029 20TH AVE, CENTERVILLE, MN 55038-9737
- **Practice address phone:** (651) 243-0017
- **Mailing address:** 7029 20TH AVE, CENTERVILLE, MN 55038-9737
- **Mailing address phone:** (516) 243-0017

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 05/07/2024
- **Last updated:** 10/22/2024